Purpose Coronavirus disease 2019 (COVID-19) has become a worldwide pandemic. The toughest issue traumatic orthopaedic surgeons are faced with is how to maintain a balance between adequate COVID-19 screening and timely surgery. In this study, we described our experience with pre-operative COVID-19 screening in patients with traumatic fractures. Furthermore, we analysed the clinical results of fracture patients undergoing confined or emergency surgery during the COVID-19 outbreak. Methods This was a case series study. Patients with traumatic fractures who were admitted to our hospital for surgery were enrolled in this study during the COVID-19 outbreak from March to April 2020. All patients were enrolled and managed using the standardized clinical pathway we designed for preoperative COVID-19 screening. Clinical, laboratory and outcome data were analysed. Results The average surgery waiting time from injury to surgery was 8.7 ± 3.4 days. The average waiting time from admission to surgery was 5.3 ± 2.8 days. These average waiting times were increased by 4.1 days and 2.0 days, respectively, compared with 2019 data. Cardiovascular complications, venous thromboembolism and pneumonia occurred in one, two and one patient, respectively. Three and two patients developed pre-operative and postoperative fevers, respectively. Conclusions We introduced a novel clinical pathway for pre-operatively screening of COVID-19 in traumatic orthopaedic patients. The delay in surgery caused by COVID-19 screening was minimized to a point at which reasonable and acceptable clinical outcomes were achieved. Doctors should pay more attention to perioperative complications, such as cardiovascular complications, venous thromboembolism, pneumonia and fever.

Background Transverse patellar fractures can be fixed using various techniques. The purpose of the current study was to assess the clinical outcomes and complication rate of a combined fixation technique using cannulated screws and the modified Pyrford technique with nonabsorbable polyester sutures. Methods and patients Between January 2015 and February 2021, 26 transverse patellar fractures were fixed with this combined technique. Preoperative data were collected from patients with transverse patellar fractures who were followed up for at least 12 months. At each follow-up visit, plain radiographs were taken. At the 12-month postoperative follow-up, range of motion of the affected knee joint and clinical outcomes, as evaluated by the Bostman scoring system, were recorded. Results The average Bostman score at the 12-month postoperative follow-up was 28.3 ± 1.5. Furthermore, the average extension and flexion of the knee joint were 1.2 ± 2.1 and 125.6 ± 6.7 degrees, respectively. One patient experienced delayed bone union and one experienced superficial wound infection. There were no other postoperative complications. One patient required removal of the device for social-psychological reasons. Conclusions The combined fixation technique with cannulated screws and the modified Pyrford technique with suture materials produced excellent clinical outcomes and a low rate of complications in the treatment of transverse patellar fractures.

Objective Neer type II fractures are common, and hook plate fixation is one of the recommended treatments. Although clavicular midshaft fractures after hook plate fixation are rare, such fractures increase patients’ suffering and worsen their functional outcomes. This study was performed to identify the risk factors for this complication. Methods From 2009 to 2018, 425 patients were admitted with Neer type II clavicular fractures. According to the selection criteria, 352 patients were included in this retrospective observational study. All patients were divided into either the complications group (patients with midshaft fractures) or the control group (patients without midshaft fractures). Data collected included patient demographics and surgical, hook plate, and screw characteristics. The chi-square test was used to conduct between-group comparisons of risk factors. Statistically significant variables were included in a logistic regression model. Results In both the complications group (n = 21) and control group (n = 331), significantly more patients of advanced age and significantly more patients treated with hook plates that were not bent during surgery developed midshaft fractures. Conclusion The risk of a clavicular midshaft fracture after hook plate fixation may be significantly increased by advanced age or a lack of hook plate bending.

Background: Transverse patellar fractures can be fixed using various techniques. The purpose of the current study was to assess the clinical outcomes and complications rate of a combined fixation technique using cannulated screws and the modified Pyrford technique with non-absorbable polyester sutures.Methods and Patients: Between January 2015 and February 2021, 26 transverse patellar fractures were fixed with this combined technique. Pre-operative data were collected from patients with transverse patellar fractures and the patients were followed up for at least 12 months. At each follow-up visit, plain radiographs were taken. At the 12-month post-operative follow-up, range of motion of the affected knee joint and clinical outcomes, as evaluated by the Bostman scoring system, were recorded.Results: The average Bostman score at the 12-month post-operative follow-up was 28.3±1.5. Further, the average extension and flexion of the knee joint were 1.2±2.1 and 125.6±6.7 degrees, respectively. One patient experienced delayed bone union and one experienced superficial wound infection. There were no other post-operative complications. One patient required removal of the device for social-psychological reasons. Conclusions: The combined fixation technique with cannulated screws and the modified Pyrford technique with suture materials produced excellent clinical outcomes and a low rate of complications in the treatment of transverse patellar fractures.

Background: Transverse patellar fractures can be fixed using various techniques. The purpose of the current study was to assess the clinical outcomes and complications rate of a combined fixation technique using cannulated screws and the modified Pyrford technique with non-absorbable polyester sutures. Methods and Patients: Between January 2015 and February 2021, 26 transverse patellar fractures were fixed with this combined technique. Pre-operative data were collected from patients with transverse patellar fractures and the patients were followed up for at least 12 months. At each follow-up visit, plain radiographs were taken. At the 12-month post-operative follow-up, range of motion of the affected knee joint and clinical outcomes, as evaluated by the Bostman scoring system, were recorded.Results: The average Bostman score at the 12-month post-operative follow-up was 28.3±1.5. Further, the average extension and flexion of the knee joint were 1.2±2.1 and 125.6±6.7 degrees, respectively. One patient experienced delayed bone union and one experienced superficial wound infection. There were no other post-operative complications. One patient required removal of the device for social-psychological reasons. Conclusions: The combined fixation technique with cannulated screws and the modified Pyrford technique with suture materials produced excellent clinical outcomes and a low rate of complications in the treatment of transverse patellar fractures.